Women Are At Higher Risk For Stroke: Here's Four Reasons Why

Jenna Congdon
Sep 26
4 min read

Stroke kills more women than breast cancer each year (1), and yet, many people believe that strokes happen more often to men. The reality is grim: women not only have more strokes than men, but they also have worse outcomes: nearly 60% of people who die from stroke are women. Women are more likely to be disabled after a stroke, and the symptoms of the disabilities they face tend to be more serious. (1)

Women have unique factors that put them at higher risk for stroke, but these aren’t often talked about. More research on women-specific stroke risks is needed to improve the diagnosis, treatment, and mortality of strokes in women. You can take control of your health by knowing your stroke risks and taking steps to improve your lifestyle and habits.

A Note About Sex & Gender

“Sex” refers to a person’s biology, which may include their genes, anatomy at birth, or physiologic functioning. “Gender” is a broad term that describes a person’s self-expression and identity. Neither sex nor gender can be divided in a neat “male” or “female” binary. Both your biological sex and your gender have an impact on your health. The vast majority of medical studies have not differentiated between sex and gender, and data from these studies is recorded as a binary. Unfortunately, data for stroke risks and outcomes in people who do not fit this binary is largely unavailable at this time (3). For the purposes of this article, “women” will refer to persons assigned female at birth, or persons who were reported as women in the statistics of the studies cited.

What is a Stroke?

There are two main types of stroke: ischemic and hemorrhagic. Strokes are sometimes referred to as “brain attacks”.

Ischemic strokes are when a blood clot or other debris blocks a blood vessel in the brain or neck so that blood can’t flow through to parts of the brain.

A hemorrhagic stroke is when a blood vessel in the brain bursts, and blood spills out into the brain tissue. The treatments for these two types of strokes are very different, but the initial symptoms often look the same.

Stroke is the fourth-leading cause of death in the United States (2), and the fifth leading cause of disability. (5) Both types of strokes are often treatable when caught early, although even with the best treatment, a person may still have long-term problems after a stroke.

Four Reasons Why Women Are At Higher Risk

Women have specific risk factors that give them a higher chance of having a stroke.

1) Hormonal Changes Throughout Life

Stroke risk increases during pregnancy due to a higher possibility of blood clots and increased blood pressure. (3)
Pregnant people who develop preeclampsia or gestational diabetes are at higher risk for strokes (1).
Hormonal birth control pills and hormone replacement therapy (often used during menopause), create a higher risk for blood clots. Those clots can move to the brain and cause a stroke. (1)

2) Migraines with Aura

Migraines are painful headaches that can be accompanied by other symptoms like nausea and light or sound sensitivity.
A migraine aura is when a person experiences symptoms preceding the painful part of a migraine. These can sometimes mimic the symptoms of stroke, such as visual changes, numbness and tingling, and speech difficulties. Women experience these types of migraines more often than men. (6)
People who experience migraines with aura are more likely to have a stroke, especially if they are younger, female, use oral contraceptives, or smoke. (7)

3) Autoimmune Disease

Women have higher rates of autoimmune diseases than men. These conditions happen when the immune system attacks the body.
Lupus and rheumatoid arthritis are two of the most common autoimmune diseases. Women with these diseases are at higher risk for stroke than men who have the same disease. (8)

4) Stressors and Mental Health

Chronic stress, depression, and anxiety are associated with cardiovascular disease and stroke. (9)
Women experience higher rates of depression and anxiety. They often juggle many roles at work and at home, which leads to added stress.
Women who experience stroke may face long-term disabilities. They may struggle to care for others or carry on their previous responsibilities.

Stroke Risks that Affect Everyone

Some factors put you at higher risk for stroke no matter your biological sex: (10)

Being older
Having high blood pressure
Having high cholesterol
Having diabetes
Smoking
Not getting enough exercise
Having a family history of strokes
Being Black or Pacific Islander

When to BE FAST! Stroke Symptoms Everyone Needs to Know

Stroke is an emergency! If you suspect that you or someone else is having a stroke, you need to call 911 immediately. Don’t wait! Do not attempt to drive if you think you are having a stroke. If you notice these symptoms, BE FAST.

B is for balance: Loss of balance or coordination.

E is for eyes: Changes in vision, such as losing vision in one or both eyes, having sudden double or blurred vision.

F is for face: One side of the face becomes weak or droopy.

A is for arms (and legs): Weakness in one limb, or both the arm and leg on the same side.

S is for speech: Slurring words or having difficulty speaking or understanding what others are saying.

T is for terrible headache: Having a sudden, very intense headache.

T is also for TIME: This is an emergency, don’t wait! Call 911 immediately. (4)

You Have the Power to Prevent Strokes

4 out of 5 strokes are preventable. (2) You have the power to stop strokes from happening.

Know your numbers: get your blood pressure, cholesterol, and blood sugar levels checked regularly.
Manage chronic conditions: diabetes, high blood pressure, and atrial fibrillation put you at higher risk for stroke. Take your medications as prescribed, and follow your doctor’s advice regarding lifestyle changes.
Adopt healthy habits: quit smoking, get regular exercise, follow a heart-healthy diet, and manage stress.
Advocate for yourself: If you think something is wrong, speak up. You know your body better than anyone else.

Wrapping Up

Stroke is a serious threat, but it’s not inevitable. By knowing your risk factors and taking action, you can lower your chances of having a stroke. Share this with your loved ones, and speak up for your health.

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